First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

BCRN Management Perspectives

Nasser H. Al-AzriBSc, MD, MRCS(A&E), MACEP

PDO

• Introduction• Disaster Management: an overview• BCRN: Definition and Historical Overview• BCRN: the unique disasters• BCRN Disasters: management perspectives• BCRN Disasters

– Pre-Event– Event

• Pre-Hospital• Hospital

– Post-Event• Discussion

Earthquakes

CyclonesTransportationCBRN

Fire Wars

Fires

HospitalPre-HospitalPre-Event

PLAN

System Testing

Resources & Capabilities

Calling List Staffing

Communication

Post-Event

Testing

Command & Roles

Supporting AgenciesTriage Treat Transport

Staff Care

Hospital Care

Surge

Patient TrackingFamilies

Hospital Disaster Notification

Planitis Syndrome

• Symptoms: itchy need to have a plan placed over your desktop or on the shelf of the department

• Signs: neat clean document seen only by HoD and heard of by staff

• Investigations: on testing staff knowledge, none, or very few, aware of the involved procedures!

Planitis Syndrome

• Treatment: Advanced Plan Life Support!

• Prognosis: Very good if treated early

Strategic Plan

• Prevention

• Preparedness

• Response

• Recovery

Paralysis Deafness

Multi-OrganisationFailure

AcuteIncidentFailure

Coordination

Capacity Communication

Success

Disaster Management: All Hazards Approach

• 80% Generic (to all disasters)

• 15% Specific (to the hazard)

• 5% Unique (to the event)

BCRN - Definition

• Biological Agents• Chemical Agents• Radiological • Nuclear

• Bioterrorism

• Industrial settings

• Healthcare facilities

BCRN Threat Assessment

Threat Assessment:

Threat ∞ Intent x Capability x Vulnerability

BCRN – Brotherhood?

• (relatively) New threats

• Unconventional weapons

• Less predictable targets

• Mass effects beyond the scene

BCRN Threats are Unique

Vertical

•Healthcare (prehospital/ hospital)

•Supporting services

Horizont

al

•Direct

•Indirect

Diagonal

•Risk Assessment & Emergency Planning

•Security (environment, science, agriculture, industry, …)

PRE-EVENT

Paralysis Deafness

Multi-OrganisationFailure

AcuteIncidentFailure

Coordination

Capacity Communication

Success

Pre-Event: Coordination

• RA (variables, data)

• Maintaining surveillance/ monitoring• Dividing roles and responsibilities • Incident Command System• Finance/ administration

Pre-Event: Communication

• Risk communication training• Community education • Communicating with action parties

Pre-Event: Prevention

• Biosafety• Bio-security• Infection Control• Quarantine• Early Warning• Environmental detection and monitoring

Pre-Event: Capacity

• Developing protection/ sheltering programmes

• Reviewing response plans• Emergency treatment/ triage/

decontamination/ facilities/ training• Logistics

BCRN – Building Capacity

• Emergency care training

BCRN – Building Capacity

• Emergency care facilities

BCRN - Building Capacity

• Emergency exercises

Plan

TrainingExercise

Biological Agents

Chemical Agents Radiological/ Nuclear Threats

Characterizing functions for

managing risks

•Health surveillance•Early warning•Quarantine •Sampling and analysis •Vaccination and prophylaxis •Epidemiological investigation•Infection control•Biosafety in health facilities

•First response•Environmental detection•Decontamination•Incident site management

•First response•Environmental detection•Facility design •Decontamination

DURING THE EVENTPREHOSPITAL

Paralysis Deafness

Multi-OrganisationFailure

AcuteIncidentFailure

Coordination

Capacity Communication

Success

Pre-Hospital: Coordination

• EMS• Police• Army• Firemen• Logistics• Others

Pre-Hospital: Communication

• Intra-agency communication• Inter-agency communication• Community communication

Pre-Hospital: Capacity

• EMS and supporting services• PPE for first responders• On-site incident management system• Mass casualty/ fatality management• Preparing hospitals for surge

http://www.fun4all.dk/eyetrickspictures/38.jpg

DURING THE EVENTHOSPITAL

Paralysis Deafness

Multi-OrganisationFailure

AcuteIncidentFailure

Coordination

Capacity Communication

Success

Hospital: Coordination

Hospital: Communication

• Inter-departmental communication• Families • Non-diagnosed cases

Hospital: Capacity

• Trained staff• PPE/ Occupational safety • Isolation facilities / control measures• Decontamination/ Treatment/ Vaccination • Protection of facility infrastructure • Waste management

POST-EVENT

Paralysis Deafness

Multi-OrganisationFailure

AcuteIncidentFailure

Coordination

Capacity Communication

Success

Post-Event: Coordination

Post-Event: Communication

Post-Event: Capacity

• Long-term health effects

BCRN Management

• Hazards• Vulnerabilities• Risks• Management – Prevention– Preparedness– Response– Recovery

Thank You